Organization
ELKHORN PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL BRANHAM NP (OWNER)
(606) 754-5793
Entity
Organization
Contact information
Practice address
112 E MAIN ST, ELKHORN CITY, KY 41522-9043
(606) 754-5793
(606) 886-9908
Mailing address
P.O. BOX 1432, ELKHORN CITY, KY 41522-9043
(606) 754-5793
(606) 886-9908
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007228
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100196230
—
KY
Enumeration date
07/13/2017
Last updated
07/13/2017
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